Prognostic value of the full-scale Periapical Index

Area of Science:

• Endodontics
• Oral Radiology
• Dental Public Health

Background:

• Periapical lesions are common findings in dental radiography.
• The Periapical Index (PAI) is a widely used scoring system to assess the severity of periapical lesions.
• Predicting the progression of periapical disease is crucial for treatment planning and prognosis.

Purpose of the Study:

• To evaluate the predictive capability of the full-scale Periapical Index (PAI) for the future periapical status.
• To assess this predictive value in both root-filled and non-root-filled teeth over a 5-year period.

Main Methods:

• Longitudinal study using full-mouth radiographic surveys from 1997, 2003, and 2008.
• Included 330 participants with three examinations and 143 with two examinations.
• Assigned PAI scores (1-5) to all teeth, recording root filling status and retreatment.

Main Results:

• Non-root-filled teeth had lower baseline PAI scores than root-filled teeth (P < 0.0001).
• High baseline PAI scores significantly increased the risk of extraction for both types of teeth (P < 0.001).
• Follow-up PAI scores correlated with baseline scores, indicating disease progression predictability (P < 0.001).

Conclusions:

• The full-scale PAI demonstrates distinct prognostic value for the course of periapical disease.
• This predictive capability applies to both non-root-filled and root-filled teeth over a 5-year timeframe.
• Radiographic assessments using PAI aid in predicting periapical disease outcomes.